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PROCARE PHARMACY, L.L.C.
STD36609 AIDS Alabama South
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Covered Entity Details
Entity Name
AIDS Alabama South
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD36609
Entity Address
4321 Downtowner Loop North
Mobile, AL 36609
Grant Number
5 NH25PS005129-03-00
Participating Start Date
7/1/2018
Last Recertification Date
5/15/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2923
3250 HARDEN ST. EXT. SUITE #300
COLUMBIA, SC 29203
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shey Lesley Thorn, Co-Executive Director
(205) 918-8224
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2020
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